Acute splenic sequestration in a pregnant woman with homozygous sickle-cell anemia

Authors

  • Carolina Bastos Maia Faculdade de Medicina da Universidade de São Paulo
  • Roseli Mieko Yamamoto Nomura Faculdade de Medicina da Universidade de São Paulo
  • Ana Maria Kondo Igai Faculdade de Medicina da Universidade de São Paulo
  • Guilherme Hencklain Fonseca Faculdade de Medicina da Universidade de São Paulo
  • Sandra Menosi Gualandro Faculdade de Medicina da Universidade de São Paulo
  • Marcelo Zugaib Faculdade de Medicina da Universidade de São Paulo

Keywords:

Anemia, sickle cell, Pregnancy, Fetal distress, Fetal monitoring, Spleen

Abstract

CONTEXT: Homozygous (SS) sickle-cell anemia complicated by acute splenic sequestration in adults is a rare event, and it has never been reported during pregnancy. CASE REPORT: A 25-year-old woman with homozygous (SS) sickle-cell disease was hospitalized at 32 weeks’ of gestation presenting weakness, abdominal pain, fever and hemoglobin of 2.4 g/dl. Abnormal fetal heart rate was detected by means of cardiotocography, and 5 units of packed red cells were transfused. Cesarean was performed at 37 weeks. Both mother and baby were discharged in a good general condition. CONCLUSION: This case report demonstrates the importance of immediate blood transfusion for treatment of fetal distress in cases of splenic sequestration during pregnancy. This treatment is essential for avoiding maternal and fetal complications.

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Author Biographies

Carolina Bastos Maia, Faculdade de Medicina da Universidade de São Paulo

MD. Postgraduate Student of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.

Roseli Mieko Yamamoto Nomura, Faculdade de Medicina da Universidade de São Paulo

MD, PhD. Associate Professor, Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.

Ana Maria Kondo Igai, Faculdade de Medicina da Universidade de São Paulo

MD, PhD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.

Guilherme Hencklain Fonseca, Faculdade de Medicina da Universidade de São Paulo

MD, PhD. Hematologist, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil.

Sandra Menosi Gualandro, Faculdade de Medicina da Universidade de São Paulo

MD, PhD. Hematologist, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil.

Marcelo Zugaib, Faculdade de Medicina da Universidade de São Paulo

MD, PhD. Full Professor and Chairman, Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.

References

Moll S, Orringer EP. Case report: splenomegaly and splenic sequestration in an adult with sickle cell anemia. Am J Med Sci. 1996;312(6):299-302.

Solanki DL, Kletter GG, Castro O. Acute splenic sequestration crises in adults with sickle cell disease. Am J Med. 1986;80(5):985-90.

Noreldeen SA, Oppenheimer C, Chapman C, Pavord S. Postpartum acute splenic sequestration in sickle cell disease. J Obstet Gynaecol. 2008;28(4):440-1.

Black AJ, Condon PI, Gompels BM, et al. Sickle-cell haemoglobin C disease in London. J Clin Pathol. 1972;25(1):49-55.

Carles G, Tobal N, Raynal P, et al. Doppler assessment of the fetal cerebral hemodynamic response to moderate or severe maternal anemia. Am J Obstet Gynecol. 2003;188(3):794-9.

Emond AM, Collis R, Darvill D, et al. Acute splenic sequestration in homozygous sickle cell disease: natural history and management. J Pediatr. 1985;107(2):201-6.

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Published

2013-03-03

How to Cite

1.
Maia CB, Nomura RMY, Igai AMK, Fonseca GH, Gualandro SM, Zugaib M. Acute splenic sequestration in a pregnant woman with homozygous sickle-cell anemia. Sao Paulo Med J [Internet]. 2013 Mar. 3 [cited 2025 Mar. 14];131(2):123-6. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1288

Issue

Section

Case Report